Contraceptives

If you are a teenager and thinking of starting a course of low dose birth control pills, you may be a little anxious about going to a doctor for your prescription  in case you are asked to have a pelvic exam or a pap test.  Relax, don’t let this put you off seeking advice on birth control if you have a sexual partner,  as it is unlikely you will need a pelvic exam in the first instance unless you think you may have an infection or severe menstrual issue. If you are 18 or over, health care providers suggest an exam as a general health check anyway.  If you’re wondering what is involved in a pelvic exam, whether it will hurt or how it is carried out, this patient handout gives a good explanation.

Take along a friend  if you prefer and seek a female doctor if you feel more comfortable- YOU are in charge of your sexual health so feel good about being responsible for yourself.

A Pap test or Pap smear is a screening test that helps clinicians detect cellular changes in the cervix (the opening to the womb at the end of the vagina) and will be recommended once you start having intercourse and /or oral sex .  If you’re like me, you’ll want to know what the test shows, how the results are interpreted, why the results are important, what is ‘abnormal’  etc. and this leaflet  gives a good overview. Pap tests are not only looking for cancer- they are to check the health of your cervix.

The only thing you have to find then is an appropriate way of managing your ‘contraception career’ for the next 30 years- it  will be trial and error to begin with but if you’re looking for a low dose birth control pill that suits your metabolism and does not cause you any side effects there are several to check out within the pages in the side bar to the RHS , maybe start with Alesse or Mircette or if you cannot tolerate estrogen at all perhaps a mini pill (progestin only) will be suitable for you.

Don’t forget the Christmas Condoms- there are some good bargains to be had  HERE  as low dose birth control pills DO NOT protect you against STIs.

Calling anyone who parents or educates young people.

Are you comfortable having a healthy conversation with a teenage girl about flavoured condoms? Would you avoid such a discussion at all costs, after all, it’s a guy thing, right? Do you think someone else should talk to her about ‘these things’ or do you believe the subject of birth control should be taboo until she ‘grows up’?

Like it or not, young people ARE having sex and many of them do not have access to the information THEY NEED that will help them to plan their own futures and the welfare of their future families. Of course, sex education will raise many more discussion topics apart from flavoured condoms but if we are to follow through with  our duty of care towards our young people then  we must be prepared to face topics that may be outside our own ‘comfort’ zone.  The quote from Philip Harvey below is to encourage you to see the ‘ big picture’ and to step forwards rather than backwards with the sexual health education of the young people who may look to you for advice.

In my light hearted post on November 5th I mentioned a non profit organisation called DKL International who supply coffee flavoured condoms to Ethiopia. The philanthropist behind this organisation is Philip Harvey who runs Adam and Eve, the largest on-line store of adult merchandise in the United States. Philip’s company now gives away 25% of its profits to good causes and provides 10% of DKI’s total funding.
Why am I mentioning Philip?

Because he is making a difference- all over the world in the arena of birth control, especially in countries where access to contraception is limited.  We don’t need Philip’s funds to make a difference though, we can do it with our own attitude to educating young people about birth control and protecting themselves from sexually transmitted infections.

This is what Philip has to say about a woman’s right to control her fertility :
“My feeling about birth control is that it has an immediate and enormous humanitarian impact for the people who get access to contraception. It has a dramatic impact on infant mortality, it has a marked impact on maternal mortality and it certainly has an impact on family welfare. The ability to control ones fertility, especially for women, is a form of liberation, that I think in and of itself is very important. And in thirty five years of doing this I have never seen a down side.”
How fortunate are we to live in a country where we have so much contraception assistance ‘on tap’, yet teen pregnancy and STI’s stats are alarming?  How fortunate are we that we have inspired teachers and health care providers working tirelessly to improve sex education programmes yet thousands of teenagers in the Western world are still left ’stranded’  from knowledge, unable to separate myth from fact when it comes to sex?
WE ALL need to do MUCH more to liberate our young people and to provide them with a thorough education in all aspects of sexual health. We owe humanity that.
PS. If you need stocking fillers this Christmas for any sexually active young people you know, there are great condom bargains to be found HERE  …and who knows, you may just find a few fun items for another favourite person in your life too?

PPS. It goes without saying that you talk to young guys about using condoms too. Watch this first video on STIs- Chlamydia is the most common STI among teens.

May 8th was the 7th annual National Day to Prevent Teen Pregnancy in Mesa County. I’d like to do my bit by including this link to a teen sex quiz- it’s not just for girls but all teens whether they are sexually active or not. If you have a teenager in the house, maybe you could ‘not so subtly’ leave the page up on the pc? It’s not a ‘fluffy’ shallow quiz that will waste your time or I would not have it here -so check it out.

If you are a teenager, I’ll bet that some of the brief dialogues in the quiz ‘case scenarios’ will be familiar to you and your friends. If you take the teen sex quiz, you will be advised to remember that no one’s looking over your shoulder so you can be honest- don’t give the answers you think are the ‘correct’ ones, choose the ones that are closest to what you would do in that situation. You never know, you could be in a for a surprise!

S.E.X.: The All-You-Need-To-Know Progressive Sexuality Guide to Get You Through High School and College

Using contraceptives for the first time can be daunting and stressful. Before you rush out for those contraceptives ask yourself “Am I really ready for sex?” You only lose your virginity once.
Running through these few questions with a simple YES or NO answer may help you to be really sure:

• Is someone putting the hard word on you to have sex, especially your boyfriend?

• Do you want to have sex before marriage or before living with someone?

• Are you forcing the sex issue with your partner?

• Do you know the person you are considering having sex with really, really well?

• Are you absolutely certain that your intended sex partner doesn’t have (or has never had) a sexually transmitted disease (STD), or even HIV/AIDS? No it won’t just ‘go away’.

• Are you sure that YOU don’t have an STD that you could pass on? Almost 30% of sexually active teens contracted a new STD within a mere six months, even among condom users (Archives of Pediatrics and Adolescent Medicine, Sept 1995)

• If this relationship does not last, will I be glad that I had sex with this person?

• If I do get pregnant, (it only takes one sperm!) am I ready to be a single parent and can I afford it on my own?

• If I can’t face becoming pregnant right now, can I go through with an abortion or give my baby up for adoption?

Any ‘NO’s in there? Or maybe you have doubts about continuing to be sexually active? If so, stand tall and take charge of your life at this point. It is responsible and sensible to wait till the timing is better for YOU. Just because ‘you’ve done it a few times already’ doesn’t mean you can’t stop for a while now (hopefully you aren’t pregnant yet and you don’t have an STD)

If you have been sexually active, just pop into a clinic and get checked out. There are plenty of places and people to talk to these days if you are confused about your relationship or sexual habits.

Trust your intuition- if it doesn’t feel right- it ISN”T- you don’t have to know why in your head.

Abstinence is practised by some young people so the use of contraceptives is not an issue for them yet ( if you want to try it- make it easier for yourself by avoiding situations where your hormones are at an unfair disadvantage, like the back seat of a car or a bedroom at a friend’s party!)

“But we don’t go all the way”

If you are having oral sex you can catch an STD.
If you are engaging in mutual masturbation, sperm from hands can get into the vagina then they swim like hell so you CAN get preggers this way AND the little devils can get through clothing too,
that’s why condoms are made of non porous, non woven material!
If you think anal sex is safe- guess what? Those little spermies can spill over into your vagina then off they swim in search of your egg. These and other similar practices mean you ARE having sex so don’t kid yourself that you’re abstaining! You are also still at risk of pregnancy and/or sexually transmitted diseases.

If he is ‘putting it in’ halfway, pulling out before ejaculating or even if you are letting him ‘put it in’ for a second- you are having sex and you can get pregnant or catch a disease that, if untreated, could cause permanent damage to your reproductive system or even death in severe cases.

If you are absolutely determined to have sex, then find out all you can about birth control options and please BE SMART - not reckless with your sexual habits.
Dying of AIDS can be agonising and bringing up a child alone is a huge responsibility.

If you wish to use an oral contraceptive pill (such as Alesse, Desogen, Levlen, Mircette, Ortho Tricyclen or Ovral) as well as condoms, (because if it’s not on, ‘it’s not on!’ right?) then please read the information about the various types and their side effects (see sidebar headings on the RHS of this site) before discussing what’s best for YOU with your doctor.

Knowledge is power- ASK QUESTIONS and don’t be intimidated, it’s your body and you’re the one who will have to cop the consequences of your decisions, possibly for the rest of your life.

When the time is right- enjoying a great sex life with a great partner is wonderful but…you are a goddess- be smart, be safe and be choosy! Here are 3 easy to read books for more help.

Teens, Sex, and Contraception

Many teenagers are curious about sex but do not know the facts. Movies, television, magazines, even the Internet portray sex as fun, exciting, and adult but rarely mention the consequences: unwanted pregnancy and sexually transmitted disease (STD). Nearly 1 million teenagers become pregnant every year in the United States; most don’t intend for it to happen. About 3 million teens get an STD every year. Proper use of contraception and latex condoms can help prevent these consequences.

The most effective way to avoid getting pregnant or infected with an STD is to not have sex (abstinence). If you choose to have sex, however, you should use an effective method of birth control and protect yourself against STD infection by using a latex condom.
Choosing the Right Birth Control

Oral contraceptives (the pill) and condoms are the methods that most sexually active teens use. Injectable contraception is the next most popular. Some methods of birth control also have non contraceptive benefits that are especially important to teens, such as clearing up acne or making menstrual periods less painful (fewer cramps) and more regular. Whatever method a teen chooses, it should be used correctly and consistently— every time he or she has sex. Even if teens use a hormonal method, latex condom use is essential to decrease the risk of STDs.

Common Methods Teens Might Choose

• Birth control pill: Oral contraceptives are an effective method for preventing pregnancy. Correct use requires that a pill be taken every day. Pill use also offers a number of health benefits. Teenagers and women who take the pill usually have less pain and fewer cramps with their periods. Most users also have lighter periods that last fewer days and occur more regularly. In addition, most teens find that their acne improves when using oral contraceptives. Most women who take the pill do not experience a change in weight. Birth control pills require a visit to a clinician and a prescription.

To read all about the side effects, precautions and use see Alesse, Desogen, Mircette, Ortho Tricyclen, Levlen and Ovral

• Male condom: Condoms are less effective than many other methods at preventing pregnancy. However, male latex condoms are the only method that has been shown to help prevent all types of STDs. Used correctly and at every act of intercourse, they provide the best protection currently available against infection.

If your partner refuses to use a male latex condom, you may wish to use a female condom to help protect yourself or say “no” to sex. Male and female condoms are available over the counter in drugstores, supermarkets, and convenience stores. You do not need to see a clinician or talk to a pharmacist to get condoms.

• Injectable: Birth control shots are highly effective at preventing pregnancy. The main side effects with the 3-month shot are menstrual changes (which can include irregular cycles, bleeding between periods, and, occasionally, heavier bleeding) and weight gain. Another change over time may be no bleeding at all.
The once-a-month birth control shot has effects similar to oral contraceptive pills. The monthly shot is more likely to cause regular, lighter periods. Injectables require a visit to a clinician’s office once every 28 days or 3 months to get another shot.
• Barrier methods: In addition to male and female condoms, barrier methods include the diaphragm, the cervical cap, and spermicides. Barrier methods must be used correctly during every act of intercourse. On average, these methods are the least effective forms of birth control—all have typical-use failure rates of about 20% or higher.
Diaphragms and cervical caps require fitting by a clinician and a prescription. Barrier methods have few side
effects, although some people may be allergic to latex or spermicides. (see post below re warning about using products containing N9)
• Emergency contraception: Emergency contraception is an option if you’ve forgotten to use your birth control method or if a method fails (for example, if a condom breaks). It can also be used after forced sex (if you’ve been assaulted). Although emergency contraception is often called the “morning after” pill, it actually can be used several days after sex, not just the next morning. The most common side effects are nausea and vomiting. Call your clinician to discuss emergency contraception as soon as possible after unprotected intercourse.

• Vaginal ring and a skin patch—are approved by the Food and Drug Administration but see my post on the strong warning about the patch. The FDA has recently changed the labelling on this product and I urge you to discuss it with your doctor if it appeals to you. With the ring, a woman inserts the round, flexible device into her vagina and leaves it in place for 3 weeks. She then removes the ring for 1 week and gets her period. She inserts a new ring at the end of this week. With the patch, a woman applies one matchbook sized patch to her abdomen, arm, or buttock each week for 3 weeks, then gets her period during a patch-free week. Both the vaginal ring and patch are very effective at preventing pregnancy and may improve menstrual regularity much like the pill. When available, both methods will require a visit to a clinician and a prescription.
Speak with Your Clinician

Each type of birth control has advantages and disadvantages. If you’re a sexually active teen, speak with your clinician. He or she can help you decide which method is best for you. If you prefer to do your own ‘home schooling’ check out these teenage favourites for your Christmas reading :
S.E.X.: The All-You-Need-To-Know Progressive Sexuality Guide to Get You Through High School and College

The Teenage Body Book

For More Information
The following Web sites address issues in sexuality and reproductive health relevant to teens.

ARHP Patient Education Site
www.arhp.org/arhpframepated.htm
This patient-oriented site from the Association of Reproductive Health Professionals includes online brochures and information. Two interactive programs on the site can help you
test your “contraception IQ” and choose the right birth control method.
Center for Young Women’s Health www.youngwomenshealth.org Sponsored by Children’s Hospital in Boston, this site provides information about health issues that affect teenage girls and
young women.
Emergency Contraception Site
www.not-2-late.com
Operated by Princeton University, this site provides accurate
information about emergency contraception (the “morning
after” pill) and a directory of clinicians who provide it.

It’s Your (Sex) Life
www.itsyoursexlife.com
This site provides sexual health information for young adults.
The information also is useful for parents wanting to address
these issues with their teenagers.
Sex, Etc.
www.sxetc.org
This online teen newsletter examines love, sex, relationships,
and health.
Teenwire
www.teenwire.com
This teen site from Planned Parenthood® Federation of
America provides information and news about teen sexuality,
sexual health, and relationships

Source: Centers for Disease Control and Prevention and “The Contraception Report”

Go grab a latte, your partner and a quiet corner for half an hour of uninterruted time to talk contraceptives.

NOW- before the partying gets under way. If you don’t have a partner but are hoping to find one, (or several) all the more reason to make sure that YOU are prepared, after all, if ‘he’ can’t see how responsible you are being with your spare stash of condoms, then is he really the man for you?

PLAN to have a great time over Christmas enjoying sex but without the shadow of a pregnancy or an STI to mar the pleasure! I know you are thinking that spontaneous sex is part of the fun but it will be a lot more fun if the stress of an unwanted pregnancy or catching a sexually transmitted disease is a ‘no brainer’.
It only takes one little sperm to make it inside that egg and snuggle down into your womb to change your life forever.

Both you and your male partner share the responsibility if you become pregnant. Only you, as a woman, have the 9 months of pregnancy and labour to go through before possibly bringing up a child on your own.
Both you and your partner, equally, deserve to enjoy great sex together.

Put aside any awkwardness or inhibitions you may have to agree on which method of protection (s) you are both going to use, then when the excitement of the moment sweeps you away you will both be ready for a good time, relaxed in the knowledge that you are ’safe’ from an unwelcome surprise further down the track, when that magic moment is just a hazy memory (or worse, a huge mistake!)

Sadly, many men today still believe that it’s a woman’s responsible NOT to get pregnant- “You ARE on the pill, babe?’ Well, take a lead from the Netherlands guys and go ‘Double Dutch’ (the pill for the woman and the condom for the man). This practise keeps the teenage pregnancy rate low and enables sexually active young couples to grow up with a healthy, responsible attitude to sex - something wonderful to share. These young people are also educated in the role safe sex has to play as part of family planning. What a good foundation for managing their lives as future parents.

It’s about time we caught up and took our heads out of the sand, put the funding into sound sex education rather than ‘abstinence only’ programs. Don’t get me wrong here either, I would include a strong argument for abstinence within the sex education curriculum but hope that the content of the course was so relevant to today’s youth that it would empower them to make choices about sex that was right for them.
Granted, the introduction of the pill in the sixties brought a new sexual freedom for women and a 99.7% effectiveness rate against becoming pregnant. I am not going into the pros and cons of the pill here because this article is about BOTH partners taking responsibility for using contraceptives.

Contraceptive pills can cause side effects in some women so I am not saying that this is only answer, quite the opposite- talk to your doctor about what is best for you as IUD’s (intra uterine devices) may not be suitable for girls who have not yet had a baby. Some women prefer a contraceptive injection. Remember though, while these methods prevent pregnancy, none of these methods of contraception will stop you from getting an STI.

If you are starting a course of oral contraceptives for the first time, it will take a while for your body to adjust to the new hormone levels so reduce the anxiety of getting pregnant by using backup protection such as condoms /spermicide) for at least the first 3 months! Again, this article is about reducing anxiety and enjoying ‘festive’ sex without the ‘headaches’.

To protect against HIV/Aids and other STI’s - VITAL if you have several sexual partners over Christmas - you are best to use a barrier method that stops sperm from entering in the first place. Do you know how long sperm can survive once ejaculated? If not, check out this site a bit further down the page.

Male condoms are easily purchased from vending machines and pharmacies without prescription. Buy good quality brands made of latex and polyurethane. I think the best site for buying on line is this one.

If you prefer to use a female barrier method consider:

• the diaphragm
• cervical cap
• female condom
• contraceptive sponge

For these methods to be effective, they MUST be used/fitted correctly, which can be a bit tricky until you get the hang of it so have several trials prior to starting that round of parties!
WARNING. More teens fail with this method of birth control than adult women.

Humour goes a long way to breaking the ice for a chat with him on this topic girls but you’ll only have to do it once or twice before it becomes second nature to you . It’s in both your interests to talk about contraceptives before you feel pressured, compromised or conflicted and you’ll find that if he’s worth it, it will bring the stress down and the pleasure up.

If you are following the latest updates on which American school clinics are going to make contraceptives available to Middle and High school students, here is an interesting article from the Los Angeles Times.

6 Denver High Schools may offer Birth Control

“DENVER — At least once a day, a teenage girl walks into North High School’s health clinic, wanting to find out whether she’s pregnant. Frequently, it turns out she is.

The city’s teen birth rate is more than double the statewide rate of 24.3 births per 1,000 girls age 15 to 17, and Denver school officials are considering a proposal to dispense contraceptives in its six high-school-based health clinics, which serve the district’s most impoverished students.

The recommendation by a task force studying the future of the clinics comes shortly after a highly publicized case in Portland, Maine, where a local school board allowed a clinic to dispense birth control to middle-school students.

The Denver proposal would affect only high school students, but it has raised similar concerns: Opponents say the easy availability would encourage youngsters to have sex….read more